I. Etiology and Classification of Glaucoma.

Abstract:—

Etiologic factors include: obstruction of lymph spaces, especially the angle of the anterior chamber; blood pressure, arterial, capillary and venous; affinity of tissues for fluids; alterations of the intra-ocular fluids; inflammations in the eye ball; and failure of a nerve apparatus to control fluid in the globe. Classification: various types of glaucoma constituting clinical entities must be recognised, as: simple glaucoma, recurring exacerbations, congestive, mechanical, and increased tension arising during uveal inflammations.

DR. EDWARD JACKSON, Denver.

Discussion by Dr. Francis Lane, Chicago.

II. Pathology of Glaucoma.

Abstract:—

(a) Changes taking place in corneal tissue.

(b) Iris angle with particular reference to the ligamentum pectinatum.

(c) Variations in the condition of the ciliary body.

(d) Consideration of the anatomical changes that take place in glaucoma secondary to retinal and chorioidal hemorrhage.

DR. JOHN E. WEEKS, New York City.

Discussion by Dr. E. V. L. Brown, Chicago.

III. Concerning Non-surgical Measures for the Reduction of Increased Intra-ocular Tension.

Abstract:—

(a) The use of myotics; their preparation, method of administration, and explanation of their action.

(b) Reduction of increased intra-ocular tension by means of various mechanical measures, notably massage, vibration massage, suction massage, electricity and diathermy.

(c) Indirect reduction of increased intra-ocular tension, brought about by lowering the general vascular pressure.

(d) The relation of osmosis, lymphagogue activity, the absorption of edema, the stimulation of capillary contractility, and the lowering of the affinity of ocular colloids for water in their relation to the reduction of increased intra-ocular tension.

DR. GEORGE EDMUND DE SCHWEINITZ, Philadelphia.

Discussion by Dr. Nelson M. Black, Milwaukee.

IV. Trephining for Glaucoma.

Abstract:—

(a) The aim of the operation is the formation of a foreign-body-free fistula.

(b) It is most important to leave uveal tissue untouched.

(c) Method of doing this explained.

(d) The area available for trephining.

(e) Method of increasing that area.

(f) Cornea splitting.

(g) Placing of trephine.

(h) Technique of using trephine.

(i) The operation is not difficult.

(j) The operation valuable as a prophylactic measure.

DR. ROBERT H. ELLIOT, F.R.C.S., Lieut.-Col. I.M.S., Madras, India.

Discussion by Dr. Frank C. Todd, Minneapolis.

V. Operations Other than Scleral Trephining for the Relief of Glaucoma.

Abstract:—

Most of the ordinary surgical procedures employed for lowering intra-ocular tension furnish a permanent cure of certain fairly well defined varieties of glaucoma. They also relieve the symptoms and retard the progress of other varieties of the disease, even if they do not perform a cure. In a third class of cases, they either have no effect whatever in arresting the disease or they hasten its march towards blindness.

What operative procedure gives, on the whole, the best results? In other words, what operation is the easiest of performance, is the least likely to be attended by serious complications and is available for the largest number of cases? Reasons for believing that of the better known procedures simple iridectomy is the least effective, while those interventions producing a large, thin, scleral filtration-cicatrix are the most valuable.

DR. CASEY A. WOOD, Chicago.

Discussion by Dr. A. E. Bulson, Jr., Fort Wayne